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Pericardial effusion - causes, symptoms, and treatment

Pericardial Effusion - Causes, Symptoms, and Treatment

author Dr. Anurag Sharma | calender December 03, 2019

The Human Heart is surrounded by a double-walled membrane called the pericardium which helps the heart to hold at the appropriate place and perform all required functions. The pericardial membrane consists of three layers known as the outer fibrous pericardium, the middle parietal pericardium, and the inner epicardium also known as the visceral pericardium.

Causes of Pericardial effusion

There are so many causes that can harm and cause damage to the pericardium sac and inflate the pericardial sac and cause pericardial effusion. Pericardial effusion is basically the leak of the liquid stored in the pericardium sac that keeps the heart inside it and keeps it on a place and causing further serious problems. The main cause of pericardium effusion is viral infections such as


Cytomegalovirus is a species of viruses in the Herpesvirales, in the subfamily Betaherpesvirinae. Human beings and monkeys provide as natural hosts for this species of virus. There are currently eight species in this genus including the type species, which is the species that infects humans.


Coxsackievirus belongs to a family of nonenveloped, linear and RNA viruses, Picornaviridae and the genus Enterovirus, which also involves poliovirus and echovirus.


Echovirus is one of the many types of viruses that attack the gastrointestinal tract. These viruses are collectively called Enteroviruses. Enteroviruses are secondary viruses only to rhinoviruses as the most common viruses in people.


HIV is a virus that targets the human immune system, our body’s natural defence mechanism fighting illness. If HIV is left untreated, a person’s immune system will get weaker and weaker until it can no longer fight off life-threatening infections and diseases. HIV can infect any age group. This is not contagious and it can be transferred to various other modes. Apart from viral infections, there are so many other issues that cause pericardial effusion such as:


It is an abnormal growth of cells in the human body that damage the other normal functioning cells that have spread to the pericardium and weakens the pericardium sac. Injury to the sac or heart from a medical procedure can inflate the pericardial sac and cause pericardial effusion.

Heart attack

It occurs when a small clot stops the flow of blood through heart veins and pumping of heart stops, without blood tissues stop working and contract pericardial sac.

Severe kidney failure

It where body fluids can rise to dangerous levels when kidneys lose their filtering ability and resulting in high blood pressure leading to a heart attack.

Autoimmune diseases

It makes your immune system mistakenly attack your own body, your immune system mainly goes after your joints and eventually causing damage to its own.

Bacterial infections

Bacterial infections including tuberculosis, get settled in the heart lining and enter the bloodstream causing damage to valves in the heart.

Heart surgery

It is done to correct the functioning of the heart, valves, and arteries of heart, a minor mistake can damage the pericardial effusion and lower the chances of living.

Underactive thyroid Hypothyroidism

It is a condition where the body produces too much thyroid and makes the heart works harder than usual and creates symptoms such as heart palpitations.

Symptoms of Pericardial effusion

Symptoms for pericardial effusion are different for each cause however the basic symptoms are laid on the same base such as sudden unexpected chest pain and pressure are common symptoms for pericardial effusion. The sudden effusion may be asymptomatic, apart from those symptoms like -

  • Fever
  • Fatigue
  • Dizziness
  • Breathing problems
  • Muscle ache
  • Nausea
  • Fainting or passing out
  • Chest pain (on the left side)
  • Uncomfortable breathing while lying down
  • Clammy skin

Treatments of Pericardial Effusion

Treatments of pericardial effusion depend upon the damage to the inflammation sac that stores the heart and on the amount of liquid that sac has lost. Medication can be used to avoid further damage at first level of inflammation of sac. There are few procedures to drain the fluid and avoid inflammation such as;

Drain the fluid

Your heart doctor may use a needle to drain the liquid from the pericardial sac and store the fluid in a container for the next procedure. The doctor will use other devices, either echocardiography or a sort of X-ray technology called fluoroscopy, to guide the work. An ECG machine will check your heart during the procedure. In most cases, the catheter will be left in place to drain the pericardial sac for a few days to help in preventing the fluid to build up again.

Open heart surgery

If there's bleeding into the pericardium, especially due to recent heart surgery or other risk factors, you might have a surgical process to drain the pericardium and repair damage. Occasionally, a heart doctor may drain the pericardium and create a "passage" that allows it to drain as essential into the abdominal cavity where the fluid can be absorbed.

Open the layers

Balloon pericardiotomy is a rarely performed process in which a deflated balloon is laid between the layers of the pericardium and inflated to stretch them.

Remove the pericardium

The surgical removal of all or part of the pericardium is normally reserved for the treatment of recurrent pericardial effusion despite catheter drainage.